Healthcare Provider Details

I. General information

NPI: 1386715670
Provider Name (Legal Business Name): BROOKS SHERRICE COLLINS-GAINES LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 07/28/2023
Certification Date: 07/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 W BOWERY ST
AKRON OH
44308-1069
US

IV. Provider business mailing address

46 W WOODSDALE AVE
AKRON OH
44301-2842
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-3864
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.1500389
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: